As we age, we often get a drop in our bone density. This is especially true for women.
By getting a bone density scan, doctors can measure exactly how strong our bones are. These scans are also the only way to know for certain if someone has osteoporosis.
The most common of these bone scans is the dual energy x-ray, known as DXA or DEXA for short. These scans look at bone health and help us understand the risk of fractures due to osteoporosis.
So a common question many people have is, “Does Medicare cover Screening DEXA Scans?” In this article, we answer the question in clear, plain English. You will also find the average costs of DEXA scans and other helpful info.
Does Medicare Cover Screening DEXA Scans?
The short answer is yes; Medicare will cover the cost of DEXA scans. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your DEXA scans. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for DEXA scans. If your scan is part of an inpatient stay, Medicare Part A may provide coverage for it.
However, DEXA scans take place in an outpatient setting most of the time. So they are usually covered by Medicare Part B.
Medicare Part B provides coverage for a DEXA scan once every 2 years. However, in some cases, Part B provides coverage for more frequent DXA scans if you have a medical condition that requires it.
For Medicare Part B to provide coverage for your Dexa scans, certain conditions must be met. These include:
- The DEXA scan is ordered by your healthcare provider for a medically necessary reason
- You last scan was at least 23 months ago or you have a medical condition that requires frequent bone scans. Some of these conditions include:
- Rheumatoid arthritis
- Chronic kidney disease
- Organ transplant
- Overactive parathyroid gland and other hormonal imbalances
- The scan takes place at a facility that accepts Medicare
- There is a high risk of you developing the following conditions:
- Sudden pain
- You are currently taking medications for osteoporosis and your healthcare provider needs to check your progress
- You have an estrogen deficiency or primary hyperthyroidism
If you meet these conditions, Medicare Part B will cover 100 percent of the costs of your DEXA scans.
Medicare Advantage plans (Medicare Part C) also provide coverage for DEXA scans. They cover everything Original Medicare covers as well as offer some additional benefits. However, exactly what it covers and how much the out-of-pocket costs are will vary depending on the specifics of your plan.
The Cost of Screening DEXA Scans
The average cost of a Dexa scan is around $150 to $250. The total cost of a DEXA scan also includes the doctor’s consultation.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover chiropractic visits?